The subchorionic hemorrhage is also referred to as subchorionic hematoma, or subchorionic bleeding during pregnancy. It is actually an accumulation of blood between the membranes of the outer fetal membrane or between the layers of the placenta itself. If they grow large, such blood clots can be cause for separation of the placenta from the wall of the uterus. In other cases, the body may reabsorb them by itself.
Frequency, symptoms and cause
The subchorionic hemorrhage is a manifestation that affects around 20 percent of pregnant women. There is no clear answer regarding the cause of such subchorionic hemorrhage. Some researchers suggest that it may be caused during the implantation of the egg, when the egg separates or tears from the uterus, which causes the clot.
Diagnosing of subchorionic hemorrhage
Some cases of subchorionic hemorrhage are diagnosed during a routine ultrasound examination, even if the woman has not been experiencing any problems. Usually, subchorionic hemorrhage is discovered at the event of vaginal bleeding during early pregnancy (during the first three months of pregnancy). Subchorionic hemorrhage can be diagnosed by means of transvaginal or abdominal ultrasound. During the examination, the doctor will assess the situation and the condition of the fetus. On the ultrasound scan, these blood clots appear as black mass within the uterus and if so, the doctor diagnoses subchorionic hemorrhage (certainly, once the doctor has checked that it is not case of miscarriage).
Treatment of subchorionic hemorrhage
As far as the treatment of subchorionic hemorrhage is concerned, there is no formal treatment. Every doctor deals with the situation individually. Some doctors advise pregnant women to continue with their normal activities, while others recommend bed rest and no sexual intercourses until the end of the pregnancy. Pregnant women are advised to restrain themselves from intense physical activities and lifting heavy objects. Some doctors prescribe blood thinners such as aspirin, Lovenox, Coumadin and Heparin, while other prescribe estrogen and progesterone therapy to assist the development of the pregnancy and the growth of the baby.
Most pregnant women affected by subchorionic hemorrhage have completely normal pregnancy and give birth to healthy children. In most cases, by the 20th week of pregnancy, bloody clots bleed themselves (causing vaginal bleeding) or are absorbed by the body itself. However, 1 to 3 percent of the cases end up with miscarriage. This usually is attributed to larger blood clots. Women affected by subchorionic hemorrhage should be aware that they are more exposed to risk of placental abruption. This is considered to be extreme pregnancy complication which should be resolved by urgent medical procedure. In case of placenta abruption, the placenta separates from the wall of the uterus, endangering the health and life of the fetus. The subchorionic bleeding as a manifestation is highly risky, since bloody clots themselves can be the cause of loss of pregnancy. Women affected by subchorionic bleeding may notice vaginal bleeding, which can actually be sign of the bleeding out of the clot. In such case, doctors recommend not to use tampons and restrain from sexual intercourse.